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SAVOAQUIN COUNTY PUBLIC HEOM SERVICES P O Box 388 • STOCKTON, CA 95201-0388 • PHONE (209) 468-3420 ERNEST M. FUJIMOTO, M.D., M.P.H., ACTING HEALTH OFFICER DONNA RERAN, R.E.H.S., DIRECTOR, ENVIRONMENTAL HEALTH DIVISION ENVIRONMENTAL HEALTH OPERATING PE I T FCR 1-04LERGROUND ``TLRAGE TANK FAC I L I TY Tank lank =err:,it Pr P/E Nmber Rec,7�!.j Til J r r Capaciiv a r,<., ^t.=_. P ail '.a+. s T._ -- — --- - 2220 001 TAIS04; 1 i0:', 5 $: 00 Unleaded 02 Cnfi!'i+ r.0 N2 TA18n402 (1 5 F: ij(1O :rnleP p :ii " 1 I led r_ ,a ,e r:i. 1�. 234 003 TA190403 nn+lf ,at FE tai?. : a.+145 y: PERMIT CONDITIONS : 1) The PERMIT TO OPERATE will be mne void if ANWAL PERMIT Fees and SERVICE Pees are fH+t. Paid and%or the U`T +s era(si fans to remain in cof:,pliance with the PERMIT CDNOITIONS 2i The PERMIT TO }OPERATE is granted to the TANK OVER who accepts responsibility for operatim.g and monitoring the i4T syst£6i according to State underground storage tank laws and regulations as well as any conditions established by San Joagtfin Ca:lty 3) The TANK OPERATOR(S), if different from the t?v*.. owner, shall operate and monitor the UST systefa accordira io t.rVS,;;E OPERATING AGREEMENT required uroder Section 25233, Chapter 5.7, Division 20, California Health and Safety Code 4) The TAfI( OWNER shall notify the Environmental Health Division of any proposed change in uperation or ownership of the :-i systei9. 5) llpor, any change in equipment., design :r operation of this facility, the PER MiT TO OPERATE will be reviewed by the Environmental Health Division. .i A construction or ref,ioval Permit is required fro�ri the Environaentral Health Division prior to any ren'mval or change of RU system equipment. Ti This PERMIT TO OVERATE shall ThA be considered reruission to violate any exist—ling lags, ordinances o- sta'.ute of other federal, state or locai agencies. e) A 'Conditional Perris" may be revf ketl if corrections are not completed by the date(s) specified on inspection. PERMIT TO OPERATE an UST FACILITY issued to; UNI VER'3'AL E..LEC:T R 1 C PO Bof 815 PERMIT'S; TO OPERATE and ANNUAL PERMIT FEE PAYMENTS are NOT TRANSFERABLE and may be SUSPENDED or REVOIKED for cause . 4 # THIS FORM "LIS—T BE DISFILAYED CL ,PI1G4.jWSLY CN TETE PFEMISES REG14IE0 FACILITY; l!NIVER'=;AL. ELEC'T'RT - 4i[: ifs IC: _C!_r=:1r_- _ Y 1CTFIR , CA _!5 '_.E= .- GILLIPiG AD �ESS; UNIVER^-;�:L ELc�:`TR1C ATTN : I_^dI«ERS:AL- EL C:TRI : Tr_TOI',, CA a._ .